Monday, July 6, 2015

MCI, health ministry look away as doctors associations violate ethics code

NEW DELHI: With the Medical Council of India (MCI) claiming it has no jurisdiction over doctors' associations and the health ministry not intervening to point out that the council was wrong, doctors' associations are back to violating the code of ethics with impunity.

Recently, the Indian Medical Association (IMA) was in the news for endorsing a commercial product and the Indian Academy of Paediatrics (IAP) was in the news for taking money from a manufacturer of health drinks for children to hold a meeting on child nutrition. Both the organisations have been in trouble over the very same issues earlier. IMA claimed it is not endorsing and IAP claimed there was no conflict of interest in taking money from GSK. Now IMA endorsement is also appearing with Dettol soap ads in print saying "certified by IMA". In both cases MCI has remained quiet.

President of the Punjab Medical Council, Dr G S Grewal wrote to the MCI president and sought action on IMA violating the code of ethics by taking money from Kent Water Purifiers for 'endorsement'. But the MCI is yet to take any action.

In August 2010, after the controversy about the IMA endorsing various commercial products, then secretary general of IMA, Dr Dharam Prakash, said the IMA had decided that it would not do any more endorsements. However, that was when MCI had issued notices to IMA office bearers and had threatened to take action against them. Later, MCI claimed it could take no action as it had no jurisdiction over associations. And now, IMA is back to taking money from commercial entities for what they claim are public health campaigns.

In the case of IAP, when the ministry brought the matter of IAP taking funding from vaccine manufacturers in 2012 to the notice of the MCI, the council wrote to the ministry that in its February 2014 executive committee meeting it considered the matter and had decided that it had jurisdiction only over individual doctors and not associations and so "the regulations maybe accordingly amended". The health ministry neither contested the MCI's position nor pointed out that it had not notified the said amendment as suggested by the council.

The MCI has claimed that it amended section 6.8 of the ethics code which refers to "code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry" and that it has taken out the word "professional associations". However, the health ministry never notified this amendment in the official gazette. It did not do so in 2010 when MCI first tried amending the code. And the ministry again did not do it in 2014 when the MCI tried yet again to take out the words "professional associations" through an amendment. It becomes law only when published in the gazette. So, the code of ethics published in the gazette in December 2009 remains the law and it clearly refers to professional associations.

MCI appears to be very well aware of the law since even in the code of ethics available on its website the words "professional association" have not been deleted. Yet, in every case to do with doctors' associations put up before MCI, it has ruled against taking any action claiming that the code of ethics was not applicable to a group or association of doctors.

"All it takes to form an association is for seven doctors to get together and register it as a society. Is it not ridiculous that what is not allowed under the ethics code for an individual doctor can be allowed if seven of them get together and form an association?" asked a senior physician.

"MCI regulates with the approval of the government of India. The MCI can recommend, but the government has to approve. Any decision of the MCI has to go to the government to be implemented. No proposed amendment has any value in law unless it is published in the gazette and notified. So, all cases involving doctors' associations where MCI claimed it could not take action on the basis of the amendment which never became law, can be reviewed. The government can do it," explained Dr MC Gupta, a medico legal expert and a doctor who has specialised in laws related to the medical profession.

Incidentally, the ministry has not explained why it decided not to notify the amendment and thus oppose the council's repeated efforts to take the professionals associations out of its jurisdiction. There was no response to TOI's questions to the ministry on the subject.

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